Cancer Registration and Reporting in NSW
The NSW Cancer Registry (NSWCR) was established in 1971 as a population-based register of
all cancers diagnosed in NSW residents. Currently, notification of malignant neoplasms is a
statutory requirement for public and private hospitals, departments of radiation oncology,
nursing homes, pathology laboratories, outpatient departments and day procedure centres.
Data collected include demographic information, brief medical details describing the cancer
and a record of at least one episode of care from each notifier. The data are further
supplemented by pathology reports and death certificates. Insitu lesions for breast cancer
and cutaneous melanoma are registered, but are not included in any reported statistics.
Classification and coding used in the Online Statistics
Module
Primary site of cancer (topography) and cell type (morphology) are coded according to the
International Classification of Diseases for Oncology, third edition (ICD-O-3). Hospitals in
NSW code disease in ICD-10 AM (Australian modification) and are required to notify the
following invasive codes: C00-C76, C80-C96. Notification of basal and squamous cell
carcinoma of skin is not required (C44, M805-M811).
For the purposes of reporting, only primary invasive cancers are counted and included in
statistics. Multiple primary cancers in the same person are counted according to the rules set
out by the International Association of Cancer Registries. In this module, mesothelioma,
Kaposi's sarcoma, lymphoma and other neoplasms of haematopoietic and reticuloendothelial
systems are tabulated as separate entities and not included in the statistics for the organs in
which these diseases were diagnosed.
This module is based on grouping ICD-O3 topography and morphology codes that are similar
to ICD-10 classifications but follow earlier ICD-9 coding used in incidence and mortality
reports from 1995. These reporting categories have been used to ensure continuity of trends.
Cancer types
Type
ICD-O3 topography and/or
morphology code
Bladder
C67
Brain
C71
Breast
C50
Cancer unknown primary
C26,C39,C42,C48,C76,C77,C80
Cervical
C53
Colon
C18
Gallbladder
C23, C24
Head and neck
C01-C14, C30-C32
Kidney
C64-C66,C68
Leukaemia
M980-M994,M9963
Lip
C00
Liver
C22
Lung
C33,C34
Melanoma of skin
C44 and M872-M879
Mesothelioma
M905
Multiple myeloma
M973
Myelodysplasia
M998
Non-Hodgkins lymphoma
M959,M967-M972,M976
Oesophageal
C15
Ovarian
C56,C57.0-7
Pancreatic
C25
Prostate
C61
Rectal
C19-C21
Stomach
C16
Testicular
C62
Thyroid
C73
Uterine
C54,C55
All other
All other
Clinical groupings used in the Online Statistics Module
Clinical groupings are cancers that have been categorised using the cancer groups that are
based on treatment categories. These groupings were developed with advice from Professor
Jim Bishop, former CCO of the NSW Cancer Institute, and endorsed by the Australasian
Association of Cancer Registries (AACR) in December 2004.
Clinical groups
Clinical group
Cancer type (ICD-O3 codes)
Skin
Lip (C00)
Melanoma of skin (C44 and M872-M879)
Kaposi's sarcoma (M914)
Head and neck
Tongue (C01,C02)
Mouth (C03-C06)
Salivary gland (C07,C08)
Oropharyngeal (C09,C10)
Nasopharyngeal (C11)
Hypopharyngeal (C12,C13)
Other oral cavity & pharyngeal (C14)
Nose, sinuses, etc. (C30,C31)
Laryngeal (C32)
Eye
Eye (C69)
Upper gastrointestinal
Oesophageal (C15)
Stomach (C16)
Small intestinal (C17)
Liver (C22)
Gallbladder (C23,C24)
Pancreatic (C25)
Colorectal
Colon (C18)
Rectal (C19-C21)
Respiratory
Lung (C33,C34)
Other thoracic (C37,C38)
Mesothelioma (M905)
Bone and connective
tissue
Bone (C40,C41)
Connective tissue, peripheral nerves (C47,C49)
Breast
Breast (C50)
Gynaecological
Cervical (C53)
Uterine (C54,C55)
Ovarian (C56,C57.0-C57.7)
Placental (C58)
Other female genital (C51,C52,C57.8-C57.9)
Urogenital
Prostate (C61)
Testicular (C62)
Other male genital (C60,C63)
Kidney (C64-C66,C68)
Bladder (C67)
Neurological
Brain (C71)
Central nervous system (C70,C72)
Thyroid and other
endocrine
Thyroid (C73)
Other endocrine gland (C74,C75)
Lymphohaematopoietic
Hodgkins disease (M965-M966)
Non-Hodgkins lymphoma (M959,M967-M972,M974)
Multiple myeloma (M973,M976)
Acute lymphoblastic leukaemia (M9821)
Other lymphoid leukaemia (M9820,M9822-M9827,M994)
Acute myeloid leukaemia (M9861)
Other myeloid leukaemia (M9860,M9862-8,M987M988,M9930,M9987)
Other specified leukaemia (M984,M985,M989-M993)
Unspecified leukaemia (M980)
Myelodysplasia (M998)
Other lymphoid haematopoietic (C42,C77 and
M974,M975,M995-M997(excl. M9963))
Region of birth groupings used in the Online Statistics
Module
The region of birth groupings used in the Online Statistics Module are based on the major and
minor groupings of the Standard Australian Classification of Countries (SACC 2nd edition),
issued by the Australian Bureau of Statistics (ABS). For more information on the countries
that form the major and minor groups detailed below, please refer to the ABS website:
http://www.abs.gov.au/AUSSTATS/[email protected]/DetailsPage/1269.02011?OpenDocument
Region of birth
Region of birth
Major group
Minor group
Australia (includes External
Territories)
Australia (inc. Ext. Territories)
Oceania and Antarctica
New Zealand
Oceania and Antarctica
UK + Ireland
North-West Europe
New Zealand
United Kingdom, Channel
Islands and Isle of Man and
Ireland
Western Europe
North-West Europe
Western Europe
Northern Europe
North-West Europe
Northern Europe
Eastern Europe
Southern and Eastern Europe
Eastern Europe
South Eastern Europe
Southern and Eastern Europe
South Eastern Europe
Southern Europe
Southern and Eastern Europe
Southern Europe
North-East Asia
North-East Asia
South-East Asia
South-East Asia
Southern and Central Asia
North Africa and the Middle
East
Southern and Central Asia
North Africa and the Middle
East
Americas
Americas
Sub-Saharan Africa
Sub-Saharan Africa
Other Oceania and Antarctica
Oceania and Antarctica
Melanesia, Micronesia,
Polynesia and Antarctica
Unknown
Extent of disease at diagnosis
Extent of disease at diagnosis is determined by the degree of spread that occurs within the
first four months from the date of cancer diagnosis:
Extent
Definition
Localised
Regionalised
Localised to the tissue of origin
Spread to an adjacent organ, muscle, connective tissue, fat, serosa or
regional lymph node*
Distant
Spread to another place in the body (metastatic)
Unknown
Unknown
Regional lymph node*
Regional lymph nodes are the single or grouped lymph nodes that are the “first” to drain the
site of a primary tumour.
Geographical definitions used in the Online Statistics
Module
Local Health District (LHD) – LHD is a NSW Health division of the state public services, as
July 2011. For more information please refer to the NSW Health website:
http://www.health.nsw.gov.au/lhd/pages/default.aspx
Local Government Area (LGA) – LGA is a based on the Australian Standard Geographical
Classification (ASGC 2006) issued by the ABS. For more information please refer to the ABS
website:
http://www.abs.gov.au/AUSSTATS/[email protected]/allprimarymainfeatures/BD1B52D132D130E7CA
2573630012F67B?opendocument
Remoteness – Is based on the ARIA+ methodology developed by the National Key Centre
for Social Applications of GIS (GISCA) and utilised by ABS. ARIA is assigned to cases from
2000 year of diagnosis. For more information please refer to the ABS website:
http://www.abs.gov.au/websitedbs/d3310114.nsf/home/remoteness+structure
Socio-economic status – Socio-economic status is based on socioeconomic indexes for
areas (SEIFA), specifically the index of relative socio-economic disadvantage, developed by
the ABS. Socioeconomic status is assigned to cases from 1980. For more information please
refer to the ABS website:
http://www.abs.gov.au/ausstats/[email protected]/mf/2039.0.55.001
Statistical calculations used in the Online Statistics Module
The following formulae apply to calculations for either males or females or total people. The
word 'cases' should be taken to mean new cancers or deaths. Age is categorised into 18 fiveyear age groups from 0 ̶ 4 years to 85 and over (85+).
Let nj be the number of cases in age group j for a particular cancer type; p j be the population
at the mid point of the year for age group j; wj be the standard population for age group j.
The age-specific rate (rj) per 100,000 persons for age group j for a given cancer type is
found by dividing the number of cases in age group j by the corresponding population:
The crude rate is the total number of cases for the cancer type divided by the total
population:
Directly age-standardised rates (s) allow comparisons between different populations by
using standard weights, wj, to calculate a summary rate from the age-specific rates. For each
cancer type, this is given by:
95% confidence intervals
1.
Calculate the standard error:
2.
Obtain upper and lower confidence intervals (UCI and LCI) for Ni, the total number of
cases for all ages for cancer type i. In this module a gamma distribution is used.
3.
Calculate the required confidence intervals, LC(s) and UC(s):
Indirect age-standardised rates allow comparisons between the observed number of
cases and the “expected” number of cases in a population. The age-specific NSW rates can be
applied to the population to derive a weighted “expected” number of cases in a population.
A standardised incidence ratio (SIR) or standardised mortality ratio (SMR) can be computed
from the actual observed number of cases divided by the expected cases.
Expected number of cases = Age-specific rate in NSW * sub-population in NSW = (E)
Observed number of cases = (O)
Standardised Incidence or Mortality ratio (SIR/SMR) = Sum O/Sum E